10 Things to Know About Rural Hospitals Scott Hulver, Zachary Levinson, Jamie Godwin, and Tricia Neuman Published: Apr 16, 2025

https://www.kff.org/health-costs/issue-brief/10-things-to-know-about-rural-hospitals/?utm_medium=email&_hsenc=p2ANqtz-99NuyHUmXgbjkdlMFYKkMXOv2heOzY7idCYUk3EVqoYJdVHPyNie1rax5iBrySBrFEq8Gb5q6zIVusSx3URDvuGq8fvg&_hsmi=356855655&utm_content=356855655&utm_source=hs_email KFF Examines Variations in Rural Hospitals’ Financial Health as Congress Weighs Budget Cuts A new KFF analysis explores data about rural hospitals’ financial health and stability at a time when Congress is considering potential federal budget cuts that could affect Medicaid and other health care funding. The findings include: Rural hospitals are more likely than urban ones to have negative operative margins, but there is quite a bit of diversity in their finances, as most rural hospitals had positive margins in 2023 (the most recent year of data available), and nearly one fifth had margins of at least 10%. Rural hospitals in states that have not adopted the Affordable Care Act (ACA) Medicaid expansion were more likely to have negative margins than those in expansion states. In addition, about two thirds of rural hospital closures since 2014 occurred in states that had not expanded Medicaid at the time. Among rural hospitals, those in the most remote areas were most likely to report negative margins, while positive margins were more common among those that had more beds, higher occupancy, were affiliated with a health system, and were not government-owned in 2023. 10 Things to Know About Rural Hospitals is part of KFF’s expanding work examining hospital finances and business practices and their impact on costs and affordability